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Histotechnology: Helping save lives, one slide at a time

Published: March 12, 2020 by Kyle Rogers

Biopsy slide under a microscope at UTHealth School of Dentistry.
UTHealth School of Dentistry Histotechnology lab develops tissue slides for analysis.
Tissue slide developed from a biopsy.
Tissue slide developed in UTHealth School of Dentistry Histotechnology lab.

What is histotechnology? Despite the vital role histotechnologists play in patient care, the profession is widely unknown. On March 10, UTSD joined with the National Society for Histotechnology (NHS) in recognizing Histotechnology Professionals Day to call attention to their important work.

Histotechnology is the preparation of tissue and slides for diagnosis by a pathologist. Through a lot of hands-on and hyper-detailed work, the science behind the profession deals with the structure of cells and their formation into tissues and organs.

As part of the Department of Diagnostic and Biomedical Sciences at UTSD, the histology lab staff is comprised of Chief Histology Technician Connie Dieringer, BS, HTL(ASCP); Histology Technician III Candy Bales, HT; Graduate Histology Technician Lisa Nguyen, HTL; and Senior Support Assistant Laurie Gurrea.

Typically, histotechnology testing centers handle anything removed from the human body that would go through pathology. At UTSD, the lab is centered to the oral cavity.

“About 98 percent of the slides we prepare come from outside of the UTHealth system,” Bales said. “We handle anything that comes in from dentists and oral surgeons, mostly from Houston area, but also from several other states and as far away as Sweden and New Zealand.”

Preparing roughly 5,000 slides per year, the team’s work is routine, but crucial.

When a biopsy sample comes in, it is assigned a number, and that number stays with the specimen much as a chart number would for a patient.

Dieringer handles all the “grossing,” which means she describes the sample, measures it, and, if needed, she sections it into smaller samples so it will process better.

Biopsies arrive in a fixative known as formalin. This water-based solution is taken out of the sample with graduated alcohols. The alcohol is then stripped with xylene, which is replaced with wax and hardened in a mold. Slides are prepared from the molds and completed after the nucleus is stained in the background.

The process requires a histotechnician to be familiar with the composition of the dyes and chemicals used and how they react with each other, as well as the composition of the tissue to be treated. Chemical reactions during the staining process produce colors which make it possible to distinguish tissue structures, allowing for the detection of abnormalities associated with diseases such as cancer.

Gurrea handles the final transcription paperwork for the slides and noted the importance of “short turnaround time of the lab, as the doctor that submitted the biopsy and patient are waiting on the results.” Generally, slides from a soft tissue biopsy are prepared and returned in less than 24 hours, depending on when the samples arrived. Hard tissue takes longer to prepare, because it has to go through a process known as decalcification.

“We’re a critical part of the patient care team,” Nguyen added. “Not a lot of people realize the steps taken before a diagnosis.”

The NHS founded Histotechnology Professionals Day in 2010 to recognize the field and help educate other allied health professionals, aspiring students, and the general public about histotechnology.

“The overall goal of histotechnology is patient care,” Bales said. “If the histologist can provide a high-quality slide for a pathologist, it will aid in a very clear, definitive diagnosis for the patient.”

For more information on histology and careers in the field, click here.

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